上海市社区老年人脑卒中危险因素暴露情况及心脑血管疾病发病风险

朱卫红; 窦瑞青; 孟珺; 古丽拜尔·马木提; 黄晨; 任碧金; 张韶伟

doi:10.11847/zgggws1118986

上海市社区老年人脑卒中危险因素暴露情况及心脑血管疾病发病风险

Prevalence of risk factors for stroke and risks of cardiovascular and cerebrovascular diseases among community elderly in urban Shanghai

摘要

摘要:
目的了解上海市社区老年人脑卒中危险因素暴露情况及心脑血管疾病发病风险，为该地区社区老年人心脑血管疾病的预防提供参考依据。
方法于2016年4月采用整群抽样方法抽取上海市杨浦区社区2 022名 ≥ 60岁老年人进行问卷调查和体格检查，分析该社区老年人脑卒中危险因素的暴露情况及心脑血管疾病的发病风险。
结果上海市2 022名社区老年人对吸烟、饮酒、高血压、心血管病、糖尿病、高血脂、短暂性脑缺血发作、房颤、左心室肥厚、超重或肥胖等脑卒中主要危险因素的暴露率分别为9.1 %、3.5 %、62.8 %、15.1 %、17.9 %、16.3 %、8.2 %、4.0 %、2.9 %、48.0 %。不同性别社区老年人比较，男性老年人对吸烟和饮酒的暴露率均高于女性老年人，对心血管病和房颤的暴露率均低于女性老年人，差异均有统计学意义（均P < 0.05）；不同年龄社区老年人比较，不同年龄男性老年人对吸烟、饮酒、高血压、心血管病和短暂性脑缺血发作的暴露率不同，不同年龄女性老年人对高血压和心血管病的暴露率不同，差异均有统计学意义（均P < 0.05）；男性和女性社区老年人心脑血管风险积分平均分分别为（9.42 ± 2.67）和（9.37 ± 2.63）分，不同性别社区老年人差异无统计学意义（P > 0.05），不同年龄男、女性社区老年人心脑血管风险积分平均分差异均有统计学意义（均P < 0.01）；男性和女性社区老年人心脑血管病高危人群比例分别为47.7 % 和48.7 %，不同性别社区老年人差异无统计学意义（P > 0.05），不同年龄男、女性社区老年人心脑血管病高危人群比例差异均有统计学意义（均P < 0.01）。
结论上海市社区老年人对高血压、超重或肥胖、糖尿病、高血脂和心血管病等脑卒中的主要危险因素处于较高的暴露水平，近半数的老年人为心脑血管疾病发病的高危人群，应加强对社区老年人心脑血管疾病的预防。

Abstract:
Objective To examine the prevalence of risk factors for stroke and risks of cardiovascular and cerebrovascular diseases among community elderly in an urban area of Shanghai city and to provide the references for the prevention of cardiovascular and cerebrovascular diseases in the elderly.
Methods We carried out a questionnaire survey and physical examination among 2 022 permanent residents aged ≥ 60 years selected using cluster random sampling in communities of Yangpu district of Shanghai in April 2016.
Results The prevalence rates of major risk factors for stroke among the participants was 9.1% for cigarette smoking, 3.5% for alcohol drinking, 62.8% for hypertension, 15.1% for cardiovascular disease, 17.9% for diabetes, 16.3% for hyperlipidemia, 8.2% for transient ischemic attack (TIA), 4.0% for atrial fibrillation (AF), 2.9% for left ventricular hypertrophy, and 48.0% for overweight or obesity, respectively. Compared to the female participants, the male participants reported significantly higher prevalence rates of cigarette smoking and alcohol drinking (both P < 0.01) and lower rates cardiovascular disease and AF (both P < 0.05). The prevalence rate of cigarette smoking, drinking, hypertension, cardiovascular disease, and TIA differed significantly by age among the male participants (all P < 0.05) and the prevalence rate of hypertension and cardiovascular disease varied by age among the female participants (both P < 0.05). The average overall score for cardiovascular and cerebrovascular disease risk was 9.42 ± 2.67 for the male participants and 9.37 ± 2.63 for the female participants, without significant gender difference (P > 0.05) but with a significant between age group difference for both male and female participants (P < 0.01). The proportion of the male and female participants at a high risk of cardiovascular and cerebrovascular disease were 47.7% and 48.7%, without significant gender difference (P > 0.05) but with a significant between age group difference (P < 0.01).
Conclusion The prevalence rate of major risk factors of stroke is higher among community elderly in Shanghai city and nearly a half of the elderly are at a high risk of cardiovascular and cerebrovascular diseases; the results suggest that prevention of cardiovascular and cerebrovascular diseases should be strengthened in the population.

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